An audit evaluating quality and completeness of the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) form documentation at Bradford Royal Infirmary

The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) form was created and implemented to encourage discussion and standardize documentation of advance care decisions for emergency management. To assess the completion of the ReSPECT form documentation at Bradford Royal Infirmary. Section 4 received special attention: "The quality of the clinical recommendations". In December 2022, data were collected retrospectively from patients' notes. To make comparisons easier, the data was converted to percentages. This was followed by an intervention that included education sessions, posters, and the implementation of required changes. Following that, a second audit cycle was conducted in February 2023 to evaluate the intervention's effectiveness. All audited forms were found in the appropriate patient files. Section 4, "The clinical recommendations for emergency care and treatment," revealed that all forms contained a signed "Do Not Attempt CPR" box and that this information was correctly transferred to the Electronic Patient Record (EPR). However, only 20% of the forms had the free text box filled out with information about the patient's needs and wants, and only 50% of the audited forms had completed subsection 1 in Section 4. The information requested on the ReSPECT form could be extremely useful if provided in greater detail. However, the forms suffer from a significant lack of data, which limits their intended utility. Furthermore, each transcription of the form lowers the quality of the data provided.